{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,23]],"date-time":"2026-10-23T21:21:51Z","timestamp":1792790511095,"version":"4.5.0"},"reference-count":44,"publisher":"MDPI AG","issue":"7","license":[{"start":{"date-parts":[[2025,7,4]],"date-time":"2025-07-04T00:00:00Z","timestamp":1751587200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"University of Medicine and Pharmacy \u201cCarol Davila\u201d through the institutional program \u201cPublish not Perish\u201d"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Antibiotics"],"abstract":"<jats:p>Objectives: Significant differences in antibiotic resistance (AR) rates and multi-drug resistant (MDR) bacteria incidence exist in patients with acute cholangitis (AC) from different countries or regions. We aim to characterize and compare the microbial spectrum and AR patterns in patients with AC from two tertiary centers in Europe. Methods: We conducted a prospective, observational, multicentric study including patients diagnosed with AC and a positive bile culture, admitted to the Colentina Clinical Hospital (CCH), Bucharest, Romania, and the Haut-L\u00e9v\u00eaque Hospital (HLH), Bordeaux, France, between April 2022 and October 2023. Results: We included a total of 144 patients from the CCH with 190 positive bile cultures (31 patients had up to five episodes of AC during the study period) and 241 identified microbial strains, and 62 patients from the HLH with 67 positive bile cultures (5 patients had two episodes of AC) and 194 identified microbial strains. The most frequently isolated bacteria were Escherichia coli (30.70%) and Pseudomonas spp. (27.80%) in the CCH group, and Enterococcus faecalis (15.46%) and Escherichia coli (22\/11.34%) in the HLH group. Furthermore, 51 (21.16%) of the strains identified in the CCH group and 15 (7.21%) in the HLH group were MDR, such as extended-spectrum beta-lactamase-producing Enterobacteriaceae or carbapenemase-producing Enterobacterales. The resistance rates for common antibiotics were 13.69% in the CCH group vs. 8.76% in the HLH group for ceftriaxone, 9.54% vs. 2.06% for meropenem, 16.59% vs. 6.70% for piperacillin\/tazobactam, and 25.31% vs. 7.73% for levofloxacin. Conclusions: This comparative study shows significant differences between these countries in terms of the AR rates and MDR bacteria prevalence, highlighting the role of bile cultures as a safe and cost-effective method for guiding antibiotic treatment, thereby reducing the AR rates and complications.<\/jats:p>","DOI":"10.3390\/antibiotics14070679","type":"journal-article","created":{"date-parts":[[2025,7,7]],"date-time":"2025-07-07T10:03:27Z","timestamp":1751882607000},"page":"679","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":9,"title":["Microbial Profile and Antibiotic Resistance Patterns in Bile Aspirates from Patients with Acute Cholangitis: A Multicenter International Study"],"prefix":"10.3390","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4998-0105","authenticated-orcid":false,"given":"Matei-Alexandru","family":"Cozma","sequence":"first","affiliation":[{"name":"Faculty of Medicine, \u201cCarol Davila\u201d University of Medicine and Pharmacy, 050474 Bucharest, Romania"},{"name":"Department of Gastroenterology and Hepatology, Colentina Clinical Hospital, 020125 Bucharest, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7133-8875","authenticated-orcid":false,"given":"Mihnea-Alexandru","family":"G\u0103man","sequence":"additional","affiliation":[{"name":"Department of Hematology, Center for Clinical and Basic Research (CCBR Clinic), 030463 Bucharest, Romania"},{"name":"Department of Cellular and Molecular Pathology, Stefan S. Nicolau Institute of Virology, Romanian Academy, 030304 Bucharest, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6837-260X","authenticated-orcid":false,"given":"Camelia Cristina","family":"Diaconu","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, \u201cCarol Davila\u201d University of Medicine and Pharmacy, 050474 Bucharest, Romania"},{"name":"Department of Internal Medicine, Clinical Emergency Hospital of Bucharest, 14461 Bucharest, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0387-4734","authenticated-orcid":false,"given":"Arthur","family":"Berger","sequence":"additional","affiliation":[{"name":"Haut-L\u00e9v\u00eaque Hospital, Centre Hospitalier Universitaire de Bordeaux, 33600 Pessac, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Frank","family":"Zerbib","sequence":"additional","affiliation":[{"name":"Haut-L\u00e9v\u00eaque Hospital, Centre Hospitalier Universitaire de Bordeaux, 33600 Pessac, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Radu Bogdan","family":"Mateescu","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, \u201cCarol Davila\u201d University of Medicine and Pharmacy, 050474 Bucharest, Romania"},{"name":"Department of Gastroenterology and Hepatology, Colentina Clinical Hospital, 020125 Bucharest, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,7,4]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","unstructured":"Miu\u021bescu, B., Vuletici, D., Burciu, C., Turcu-Stiolica, A., Bende, F., Ra\u021biu, I., Moga, T., Sabuni, O., Anjary, A., and Dalati, S. 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